By: Raul J. Rodriguez MD, DABPN, DABAM, MRO Special to the Boca and Delray newspapers
So Amendment 2 has passed and Marijuana has been legalized for medicinal use in the state of Florida. The conditions that can be treated legally with medicinal marijuana are cancer, epilepsy, glaucoma, HIV, AIDS, amyotrophic lateral sclerosis (ALS), Crohn’s disease, Parkinson’s disease, multiple sclerosis, and post-traumatic stress disorder (PTSD.) These are all considered “debilitating” diseases that have the potential to derive symptomatic relief from the active ingredients found in cannabis. Of these conditions, I would like to discuss the clinical application of medicinal marijuana in the treatment of post-traumatic stress disorder (PTSD.)
Post-traumatic stress disorder (PTSD) is a particularly debilitating condition that can result from exposure to a severe life-threatening traumatic event. The types of traumatic events that are often implicated in the development of this disorder include combat exposure in war, physical assault, sexual assault, motor vehicle accidents, and natural catastrophes. In some individuals that are exposed to these types of events, a disorder can develop where they start to have problems related to intrusive memories and other forms of re-experiencing the trauma. They can start having flashbacks, recurrent intrusive thoughts, nightmares, mood disturbances, anxiety, agitation, irritability, hostility, hypervigilance, loss of interest or pleasure in activities, and feelings of guilt. These types of symptoms will often lead to severe disruptions in most facets of functioning. Individuals affected will typically experience a decline in performance in school, at work, and in their personal relationships. The distress caused by these symptoms frequently lead to substance abuse, self-destructive behavior, and social isolation. The need for treatment is apparent, which in part contributed to the movement to legalize marijuana.
Some of the active ingredients in cannabis can provide relief for many of the symptoms experienced with PTSD. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are the 2 most frequently discussed active ingredients in cannabis. THC is the component most associated with the euphoric effects of marijuana while CBD is often associated with the more medicinal effects. In the treatment of PTSD, CBD is the more helpful compound. This is why the strain of marijuana that has been legalized for medicinal use in Florida has a high proportion of CBD to THC, as compared to other strains that are used primarily for recreational purposes. Cannabis Sativa, also known as “Charlotte’s Web” is the low-THC strain developed by the Stanley Brothers in Colorado. They developed this strain to treat a young girl named Charlotte who suffered from intractable seizures caused by Dravet Syndrome. The amount of THC is kept below 0.3% by the Stanley Brothers to maintain consistency of the product. Originally, this strain was called “Hippie’s Disappointment” due to the low capacity for euphoria. Cannabis Sativa is also used to create extracts and CBD oils, also for medicinal uses. On the surface this strain of marijuana appears to be the safe and logical solution for finding a true medicinal option for the treatment of PTSD.
In the world of modern medicine, solutions that may appear safe and logical on the surface often have underlying problems. Medical marijuana exemplifies this concept. To maintain appropriate objectivity and perspective, all comparisons and analyses will be made to the same standard applied to any other medication or clinical procedure. The first basic issue with Cannabis is side effects. Contrary to popular belief and to what the media depicts, even Cannabis Sativa has side effects. The common side effects include dry mouth, dizziness, depression, lack of motivation, paranoia, anxiety, addiction, increased appetite, memory impairment, and respiratory problems (if smoked.) These are not rare side effects. These are common ones. Some of these, such as depression, addiction, anxiety, and paranoia, can escalate to catastrophic levels.
Please look for part 2 of 3 in the May issue*
Dr. Rodriguez is the founder, CEO and Medical Director of the Delray Center For Healing, which specializes in comprehensive outpatient treatment of PTSD, Depression, Anxiety, Bipolar Disorder, & Eating Disorders.